Impact of the public health insurance system on "equity in access to health care Panel Analysis with Kakwani Index
Hisao Endo, Professor, Faculty of Economics, Gakushuin University
The Office of Pharmaceutical Industry Research Naoya Fujiwara, Senior Researcher
The Office of Pharmaceutical Industry Research Takahito Kushi, Senior Researcher
(No. 21: Published July 2004)
A public medical insurance system with mandatory enrollment is considered to have not only the function of insurance to reduce the risk of injury or illness, but also the function of ensuring fair access to medical care by reducing the co-payment of medical expenses for low-income and high-risk groups (those with high probability of developing illness, such as the elderly). The purpose of this study is to clarify how the existence of public health insurance affects the equity of access to medical care. Specifically, we will analyze the involvement of public health insurance systems in the GDP ratio of health care costs and the regressivity (progressivity) of health care out-of-pocket costs.
The results of the empirical analysis conducted for OECD countries indicate that the existence of a public health insurance system has the effect of lowering the ratio of health care costs to GDP. In the seven countries except Germany and the Netherlands, where high-income individuals do not have to or cannot purchase public health insurance, it was also found that the existence of public health insurance reduces the regressivity of the health care cost burden and facilitates access to health care for low-income individuals.